Monday, 6 May 2019

When carers are burnt out, who cares for them?

It is estimated that there are over 210,000 caregivers and counting in an ageing Singapore, with some 70% of them aged 40 and above.

Anyone caring for a frail or disabled loved one will experience fatigue and stress and eventually into a state of mental and physical exhaustion known as caregiver burnout.

Among carers of stroke survivors, 40.2% have depressive symptoms, according to a 2017 study by the Institute of Mental Health and the National University of Singapore.

Carers of cancer patients are also at greater risk of developing depression than the general population, according to a Singapore Medical Journal study.

Read more on how and where to get help @

Forum: Prudent to have limits to Medisave withdrawals

Mr Robin Yiu is right when he laments that the Flexi-Medisave annual limit of $200 is woefully insufficient when one seeks specialist medical care in the hospitals (Consider raising Flexi-Medisave limit, May 2).

Each full-paying specialist consultation charge in restructured hospitals before Pioneer Generation considerations is already way beyond $100, while private specialists will charge multiples of that.

But when the purse strings are opened, there is a tendency for medical expenses to balloon to fit the budget available for it.

Remove any constraints and the medical fraternity can empty out a Medisave nest egg in no time.

Pioneer Generation privileges available to Mr Yiu's wife for chronic ailments amounts annually to $540, while $500 can also be withdrawn using Medisave, and another $200 via Flexi-Medisave when spouses are also beyond the age of 65.

The limits of Medisave withdrawal have incrementally expanded from $300 to $500 now.

Of course, patients and doctors will always clamour for more, but enough must be left over for emergencies, and even more healthcare still when we become more stricken towards end of life.

Meanwhile, this is almost always enough in the primary healthcare setting for the appropriate management of two or three chronic conditions, with a little topping up if there is a fourth condition. Where necessary, spousal and children's Medisave can also be mobilised for utilisation.

It is expected that if patients want the latest, new-fangled treatments, which some do despite financial limitations, even where these are superfluous and cost-ineffective, then the sky is the limit because medical expenses are indeed extremely expansile.

Medical practitioners can exploit patients the way they innocently want to be mercilessly exploited, not judiciously treated.

Patients should use a primary healthcare professional they are assured of and entrust to him their medical problems.

A competent primary-care physician will know when more sophisticated, complex and much more exorbitant care in the tertiary-healthcare environment is needed for his patients and then refer them when necessary.

Yik Keng Yeong (Dr)


Doctors struggle with families’ lack of understanding of HOTA

While the pool of potential organ donors has increased since the Human Organ Transplant Act (HOTA) was enacted more than 30 years ago, the overall organ transplant rate is still low, with more than 400 people waiting for organ transplants as at the end of last year, according to figures from the Ministry of Health.

Under HOTA, all Singaporeans and Permanent Residents aged 21 and above are deemed donors, unless they chose to opt out. It allows for their heart, kidneys, liver and corneas to be harvested for transplantation when they are declared brain-dead.

But there are challenges when putting the legislation into practice, doctors told CNA.

One major hurdle they face is the objection from family members.


You may want to read What is HOTA all about?

Older people with a poor sense of smell are 50% more likely to die in the next 10 years, study finds

Image for illustration only

A poor sense of smell in retirement may be a warning sign of an early death, researchers have warned.

A study of more than 2,000 people in their 70s and early 80s found that those who had trouble recognizing common odors were almost 50 percent more likely to die in the next ten years than individuals with sensitive noses.

Even healthy people at the beginning of the study had a higher death risk if their sense of smell was impaired - suggesting the problem may flag up deteriorating health years before more serious problems appear.

Scientists believe smell tests could one day become routine in doctors' surgeries.


You may want to read No smell is one early marker for Parkinson disease